Getting Used to an Insulin Pump

Posts tagged ‘Hypo’

Ban(ne)d

Tomorrow night I’m trying out with a band, they want a guitarist and I kinda play guitar…badly, or at least I used to about four years ago. Here’s a picture to prove it:

Me, Playing Guitar!

Me, Playing Guitar!

As I say I’m a little out of practice and probably need a few go’s before I can actually play along with their music so I’m hoping they’ll be patient.

Anyway last time I lived the rock ‘n’ roll lifestyle I was using a pen to inject four or five times a day, I didn’t do carb’ counting and I frankly managed my diabetes by crossing my fingers and having a lot of hypos and highs so I’m hoping it’s going to be a bit easier what with all this modern technology I’ve managed to persuade the medical establishment to supply me with.

However What I do have now is of course plugged in to my belly 24/7 and also has a three thousand quid piece of kit hanging off me, this is why I’m going to have to think carefully about my set-up before I head out of the house tomorrow night. I think I’m due an infusion set change tomorrow night so I’ll probably do that before I go, this means I need to pick a spot…and a side of myself that will cause the smallest inconvenience in terms of catching cannula on sticky out bits of guitar or continually rubbing said guitar over infusion set and causing discomfort.

Further to this is of course the fact that I have experienced most things which come up in every day situations since getting the pump, however I haven’t stood up for a couple of hours with a frankly rather heavy guitar (I own one of these now) which weighs about nine pounds, that’s about four kilo’s if you’re a youngster! Also there’s the unpleasantness of hefting guitars, pedals and even worse amplifiers up and down stairs to practice rooms and back to your car afterwards.

So with all these things considered am I having second thoughts about going tomorrow night?

Don’t be silly,  I’ll just do a lot of blood test before, during and after and hope Im lucky enough not to stab a finger so it hurts when I press the strings down, if I do I’ll just have to live with the pain. I’ll just make sure they are all aware that if I play particularly badly it may be a mixture of nerves, not having practised properly for about three years and low blood sugar all combined in to an ear splitting wall of feedback and noise. Or maybe that’s what they want???

Wish me luck 😉

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I Opened The Door And…

…Influenza!

Deanne and I have both had the flu (must be proper flu not man flu as she has had it as bad as I have) since Tuesday this week which has meant all the clever stuff I was planning on posting this week (honest) has gone out of the window. Thankfully we’re on the mend…finally, however as my brain still hurts and I need to get myself back in order I thought I’d just post the first scene I wrote for a book I started in 2005 that only ever got up to about three and a bit thousand words before I realised I had more important things to think about at the time, like getting a better job and stuff!

It was going to be a thriller about a diabetic guitarist in a rock band who got framed for the murder of one of his bandmates but I didn’t really have a plan after that, which is probably one of the other reasons it fizzled out! There are a few sweary words in it so please excuse that. Anyway, it’s not much but here you go…


The first thing I notice is that the back of my hand feels warm, and sort of slimy.  I look down.  My vision seems to follow the movement of my eyeballs after a couple of seconds.

It’s my left hand and its red, the hair on my arm is stuck to my skin.  I think the phrase I’d be looking for is ‘caked with sweat’ but currently I don’t seem to be geared up for thinking.

My temples are throbbing, as my brain starts to restart I realise that I’ve had a hypo.  It must have been quite a bad one otherwise there wouldn’t be blood.

The sweat is fairly normal but I must of cut something or there wouldn’t be blood, either on my hand or…bloody hell, on the carpet.  That’s going to be a bugger to clean up when I’ve come round properly.

There is a slightly more immediate problem though.  I’m lying on the floor in my bedroom but none of my limbs seem to be coordinated enough to actually carry me towards the kitchen.

I’m thinking the only reason I’ve come round is because of the adrenalin pumping round my body from whatever injury it is I’ve given myself.

I can reach the drawers from where I’m laying, I manage to turn myself over enough that I can use both my arms and my legs to lever myself into an unsteady upright position.

I’m definitely not stable but thankfully the kitchen is just down the corridor and the corridor isn’t too wide!

I make my way along by propping myself up with my arms on either side of the passageway.  I’m sure I look pretty dumb, but for one thing there’s no one here to see me and for another I wouldn’t care if there was.  In fact I wouldn’t be like this if there was somebody else here!

I meander through to the kitchen.  The adrenalin seems to be doing its job because by the time I get there I can almost stand of my own accord again.

I reach into the fridge while supporting myself with my hand on the bench.  I take the orange juice out with one hand and tip the carton back so it pours in to my mouth.

I never like the feeling of the raw cardboard against my lips.  I should probably cut the container so the top layer of waterproofing doesn’t rip off like that.

I don’t know how much I drink, I finish it though.  ‘Ah crap!’  My first words after hypos tend to be colourful metaphors of the four letter variety.

I put some bread in to the toaster and push the knob down, guess I need to wait until it’s done…


Two possibilities are that you will:

A. Think that is okay!

B. Think it is utter tosh and that you won’t get those few minutes of your life back in which case my work is done as I have been bed bound four out of the five days of this week and will personally definitely not get them back 😛

Have a good weekend.

Up and Down

Up and Down

Up and Down

Having an odd day today – Control wise!

These are my blood test results since midnight:

Time 24hr Blood Glucose in mmol/l
02:30 31.7
05:02 27.0
07:01 23.8
11:32 13.2
13:00 7.8
14:26 2.9
15.11 3.9
16:17 2.9

Let me give you a bit more information…

Deanne and I had a nice meal together last night after we’d put the Young ‘un to bed, it consisted of Pizza, Garlic bread and then a wonderful chocolate Torte all from Waitrose (other supermarket chains are available!) I made some frankly random guesses about the carbohydrates but did do a bit of checking up afterwards and thought I’d massively overestimated. But as it turned out I hadn’t!

I woke up at 2:30 ish needing to go for a wee (sorry too much info.) but I also felt pretty ropey so decided to do a blood test as well, the 31.7 was not what I was expecting, usually my highs only go up in to the 20s even if I’m ill (which I suppose I might actually be).

I didn’t consider that my infusion set may not be working properly because frankly it was half past two in the morning and I wasn’t really thinking straight. So I stayed up and watched some six-s-side and beach volleyball on TV as it was on when I turned on the telly. I did the next blood test at 5 and was a bit shocked to find out I’d only gone down by 4.7 mmol/l. so I did another bolus and went back to bed.

Got up this morning and realised there was probably something up with the infusion set so I changed it (it was due today anyway) and waited to see what happened. Had my lunch at half eleven and was still 13.2 the pump gave me a couple of extra units bolus to get my blood sugar down!

It worked. The rest of this afternoon my blood sugar has been rock bottom and I’ve been eating Jelly Babies like there is no tomorrow.

I don’t feel particularly unwell, although I’ve had such an up and down day that it’s hard to say for certain and what I’ve eaten hasn’t been massively different to normal so I really have no idea what’s caused it.

I’m not asking for sympathy, advice or even acknowledgement from anyone I just thought it might interest those of you who are more newly diagnosed that even after 35…nearly 36 years of doing this I can have a bad day. I’m not trying to depress you all just reminding you and all of those who support and live with you that you can never take Diabetes for granted.

…and on that cheerful note I’ll sign off for now 😛

Here’s Looking at You Diabetics!

Looking Ahead

Looking Forward

Well, new year new me! Actually that’s a lie I’ve not made any kind of resolutions and I don’t intend to change anything in particular, however I am quite excited as to what the next 12 months might hold for myself and all the other Diabetics in the world.

Personally I think the most exciting short term news is the fact that there are some serious jumps being made in CGM, that’s Continuous Glucose Monitoring, technology at the moment, I’m hoping that by the end of this year or not long  after we are going to be seeing the first commercially available CGM enabled Insulin Pumps, that is Pumps with a continuous feedback loop that monitors your BM and adjusts your insulin intake to compensate.

Of course like most scientific developments this could actually take a lot longer than it should and will need proper sign off by whoever the governing bodies are, however it will certainly be a big step, when available, to giving us Type 1s a fairly normal life (minus the obvious infusion set changes and being woken up in the night when your pump battery runs out, etc.)!

Next of course are the ongoing promises of some kind of genetically engineered “cure” for Diabetes, as far as I can make out at the moment the scientists are looking at a number of ways of doing this, for instance putting beta cells in one way membranes which carbs can get through but white blood cells can’t so they pump out insulin without getting destroyed. Another one is fiddling about with your existing biology to regrow the cells in your pancreas that do all the hard work (that they don’t at the moment). This is much further off and I think of all the things happening the First thing I mentioned here the “Artificial Pancreas” is probably most close to fruition and also most exciting for all of us.

The Notts Type 1 Diabetes Group is also steaming on with various members doing various exciting things, the next of which is apparently some kind of video performance thing (sic.) by the committee members prior to the next meeting but I’ll tell you more about that when I’ve had some more details myself. Also just a quick aside, I apologise for not updating the web pages, however it does tend to be a darn sight easier and less disruptive updating Facebook and Twitter so I tend to do those most often and leave the website for if there is anything specific that is worth putting on it!

Personally this year is quite a big one as Deanne and I have a trip to Australia for a month coming up in the not too distant future, the reasons behind this are several-fold but it’s mainly to show the Little-‘Un off to the in-laws, but while I’m there I think I might look in to what’s going on Type 1 Diabetes wise as it is always interesting to get a different perspective on things.

Other than that it’s business as usual, work is busy, life is packed with things to do including childcare, housework, open mic’ nights and attempting to write a novel. Apart from that of course it’s a breeze.

Look after yourselves in 2012, do lots of blood tests, eat well, drink well and most importantly have lots of fun!!!

🙂

Happy (ever so slightly belated) new year!

Tired

Tired Out

Having A Nap

Okay so it’s partly my own fault, the last couple of Sunday’s I’ve been going out (at 9pm) to an open mic’ night with the guy who lives next door to me, this has meant that I’ve got home both times at something close to midnight, which is way past my bedtime! As well as that I’ve had quite a few busy days at work due to colleagues being off and the surprising number of spam e-mails that seem to be circulating at the moment.

In any case I’m feeling a bit run down, of course  that’s not unusual at this time of year, I’m sure we’ve all heard of SAD (Seasonal Affective Disorder in case you haven’t) and of course the nights are drawing in and the temperature has plummeted.

However it’s only really the past year or so that I’ve become more acutely aware of the effect that the temperature and other factors have on my diabetes, and it’s definitely the first time I’ve been connected to a pump when the seasons have changed so dramatically so I’m wondering whether there will be anything different I need to do?!

Should I re-do all my basal rate tests to see if the base rate I am having throughout the day needs changing, or if my bosul needs will go up or down when I eat. I guess like everything else it is just a case of living it and seeing what happens as I do. I guess if I seem to be having a lot of hypos or high blood sugars then I may need to adjust but until that happens I should probably just keep on keeping on!

A Long Afternoon

A Big Clock

When's Home Time???

This afternoon has been a very slow one to pass, as you can probably tell from the title I’ve given this post, however on the bright side it’s nearly over now!

Part of the reason it has seemed long is ’cause I’m doing some frankly not super-interesting stuff, however the other reason is that I have been quite low twice, a 3.3 mmol/l at 13:35 and a 2.7 mmol/l at 15:16. “Why so low” you ask? To be honest I have no idea, I had my lunch at about 11:30 in the morning (a habit I picked up many years ago when I worked with my Dad) so the one o’ clock test was two hours after lunch and then the three o’ clock one was after a particularly dull meeting.

Because one of the team bought in some gingerbread men I also had one of those after the last couple of Jelly Babies, at 7.8 grams of Carbohydrate it’ll hopefully be enough to keep me going without sending me sky high.

Anyway I thought I should give a quick update on how life is going as I have been a bit busy at work lately and not really had the time to craft my prose on all things Insulin Pump.

It’s been over four months now since I first got plugged in, it has been  a fairly steep learning curve since day one but it is now a part of my normal day to day life and doesn’t really cause me any problems as far as changing  the infusion set or filling up and putting in a new vial of insulin (which I just had to do at my desk at work!).

My control is obviously only as good as my guessing of carbohydrates and for the most part it doesn’t seem to be going too badly, for instance I had a HbA1C test a while back which tells you how your blood sugar average has been over the previous three or so months and it came out at 7.0 mmol/l. This is fantastic and I believe the best result I’ve ever had for one of these.

I’ve also pretty much come to terms with doing exercise while plugged in, at volleyball now I tend to eat about 12 jelly babies (around 60 grams of CHO) over the course of a two hour training session and that seems to keep my blood sugar fairly steady.

I still haven’t got round to doing all my fasting blood glucose tests, partly because I have been lazy but mostly because it is hard to guess when a good date will be for waking up every two hours in the night when you have a hectic lifestyle and a 15 month old baby, however I really must try and do at least one before my appointment to see the consultant in September in order that I can get as near as possible to perfect. I know almost certainly that my blood sugar goes up at some point in the night because when I  wake up in the mornings I tend to be hovering around between about 8 and 14 mmol/l, even if I haven’t eaten anything prior to going to bed with a 5 mmol/l.

Of course whatever happens I am still Diabetic and therefore my control will never be perfect but all that means is that there is always room for improvement and work on my control.

I feel like I’m rambling now so I’ll bid you adieu and write again some time soon when I’ve gathered my thoughts.

One last thing, I recently wrote a short article for the Nottingham’s NCT (the UKs largest charity for parents) Newsletter, I have scanned this in and posted it here if you are interested in reading something totally unrelated to Diabetes that I wrote!

 

In the words of the Cat: “what is it?”

Insulin and Carbohydrate

What Happens to Carbohydrate with Insulin

Okay, I’ve had enough of what I’m meant to be doing at the moment and anywhere to get a drink or something to eat has shut so I thought I’d start on my A-Z of Diabetes, or at least trying to give a bit of background on what it is and what all the things I talk about mean so…

Type 1 Diabetes, also called Diabetes Mellitus is an autoimmune disease, that is it is a problem with your immune system, in my case I believe I got a virus of some sort when I was about 22 months old, my white blood cells killed off the virus but then didn’t know where to stop and decided that my beta cells in my pancreas were also BAD so they started destroying these as well!

Beta cells have a few roles but the most important of these (to a Type 1 Diabetic at least) is that they pump out insulin and (sort of) glucagon. Both of these hormones have an effect on carbohydrates, insulin turns carbohydrates in your blood stream in to energy which your body can then use to power itself, glucagon turns stored energy, e.g. fats, etc. in to energy if you don’t have enough carbohydrate in your blood stream when you need it.

Obviously you need energy to power pretty much anything you do, if you do not have enough then parts of your body can start malfuctioning! This is called “low blood sugar” or a “Hypo”. I have experienced a whole gamut of different types of hypo and personally find they tend to be different dependent on what I’m doing at the time, for instance if I am exercising, not necessarily full on cardio-vascular body pummeling, can be as low impact as walking (or more likely these days pushing a pushchair!) then I will tend to have a muscular hypo, that is some muscle group in my body, possibly all of them, won’t have enough energy and therefore I’ll get wobbly legs or arms or possibly collapse on the floor or else not be able to get out of a chair.

Worse for a number of reasons are hypos that occur when I am thinking hard, e.g. writing a document at work or doing a brain intensive DIY task, in these cases the organ in my body using the most energy is my brain and so when I run out of energy my brain ceases to function properly. The reason this is particularly bad is because my brain, being short of energy, is often unable to realise that it is short of energy and so I miss the signs I would normally pick up and just get lower and lower until (on occasion but not so much these days) I become unconscious, it can also cause bad moods, arguing (more than normal) and a general change in personality. If it is one of these ones the best thing to do is just to tell me it’s a good idea if I do a blood test, I might well argue but if I do too much you can just leave me until I collapse and then call an ambulance 🙂

So, because I am unable to produce my own insulin I need to somehow get insulin inside my body, over the years this has been by syringe and needle, plastic syringe, pen injector and most recently an insulin pump (hooray), all of these devices do pretty much the same thing but to different degrees of control, syringes were okay but you simply sucked up as much insulin as was required by eye and injected it, insulin pens were a bit better as you wound up the dose and it would give you the same dose, standardised, each time you wound it up on the pen so you knew you were getting exactly 10 units if that is what you selected. I’ll come to the pump in a minute!

Of course to control the level of insulin you are giving yourself you also need to find out how much carbohydrate is in your body, originally when I (in fact my Mum and Dad) had to do this you had to catch some urine in a test tube and add some water and a pill which would then change colour to give an indication of how “sugary” I was, e.g. whether I needed to exercise to try and bring my blood sugar down or if I needed to eat something, they were pretty much the only options available back in 1976. Then they bought out dextrostix, which were plastic sticks with a reactive piece of chemistry on the end which, again, changed colour when you wee’d on it, somewhat simpler and less prone to accidents or mistakes in the process. Nowadays I have a blood test monitor, this involves pricking my finger with a lancet to draw some blood, this blood then goes on to a strip, not a world away from the Diastix I used to use but plugged in to a machine which then gives a reading as to your blood sugar, this has a number of advantages!

The old Diastix used to have a number of colours for the different readings, I believe that “blue” meant your blood sugar was between 0 and 9 millimoles per litre (mmol/l the standard unit of measurement until fairly recently) green was between 9 and 12 (or something like that, it was a long time ago!) and then a range up to brown which was frankly much too sugary! Bearing in mind that a normal blood sugar is meant to be between 4 and 8 it obviously didn’t give a lot of fine control over your blood sugar. Also it meant whenever you wanted to test your blood sugar you needed to be able to pee…and find somewhere to pee! Finally because it takes a while for your body to process carbohydrate and eject it the tests were always about an hour or two behind where your body was currently at.

Blood tests are more or less instant, you still have to carry kit about with you but no longer need to find somewhere private to test and the results are to 0.1 mmol/l, in this way my average blood sugar results have come down from somewhere between 9 or 12 to about 7 these days which is obviously desirable and in fact makes me feel much better about myself.

So these days I need to do blood tests to check my blood sugar, guess the amount of carbohydrate in food I am eating and adjust my insulin accordingly (a bit more about insulin types another day).

The pump is a fantastic device, it is programmed with the amount of insulin I need to deal with 10 grams of carbohydrate (CHO) and the amount I need to bring my blood sugar down by 1mmol/l (0.3 units I think) and when my blood test monitor tells the pump what I am eating (which I program in to it) and what my blood sugar is it decides how much insulin to give me for the food and to adjust my blood sugar to the right level and then pumps it in to me! Technology is fantastic.

That’s it for now, gotta go. I’ll continue this another day, feel free to ask questions if you want more info about anything I’m talking about and remember these are my views and opinions and probably wrong on a number of counts!

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